The urologist's view of male overactive bladder: discrepancy between reality and belief in practical setting

Yonsei Med J. 2010 May;51(3):432-7. doi: 10.3349/ymj.2010.51.3.432.

Abstract

Purpose: In order to gain insight into the physicians' awareness of and attitude towards management of overactive bladder (OAB) in males, we performed a nationwide survey of the current strategies that urologists use to diagnose and manage OAB in male patients.

Materials and methods: A probability sample was taken from the Korean Urological Association Registry of Physicians, and a random sample of 289 Korean urologists were mailed a structured questionnaire that explored how they manage benign prostatic hyperplasia (BPH).

Results: A total of 185 completed questionnaires were returned. The consent rate in the survey was 64.5%. Eighty-one (44%) urologists believed that of all males with lower urinary tract symptoms (LUTS), 20% or more had OAB and 72 (39%) believed that 10-20% had OAB. Half of the urologists surveyed believed that the most bothersome symptom in male OAB patients was nocturia. Seventy-three percent of respondents reported that they prescribed alpha blockers with anticholinergics for first line management, while 19% of urologists prescribed alpha blocker monotherapy but not anticholinergics for OAB patients. Though acute urinary retention (AUR) was considered the anticholinergic adverse event of most concern, the most frequently observed adverse event was dry mouth (95%).

Conclusion: The present study provides insights into urologist views of male OAB. There is a discrepancy between the awareness of urologists and actual patterns of diagnosis and treatment of male OAB. This finding indicates the need to develop further practical guidelines based on solid clinical data.

MeSH terms

  • Adrenergic alpha-Antagonists / therapeutic use
  • Cholinergic Antagonists / therapeutic use
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Physicians / psychology*
  • Practice Patterns, Physicians'
  • Prostatic Hyperplasia / diagnosis
  • Prostatic Hyperplasia / drug therapy
  • Prostatic Hyperplasia / pathology
  • Surveys and Questionnaires
  • Urinary Bladder Neck Obstruction / diagnosis
  • Urinary Bladder Neck Obstruction / drug therapy
  • Urinary Bladder Neck Obstruction / pathology
  • Urinary Bladder, Overactive / diagnosis*
  • Urinary Bladder, Overactive / drug therapy
  • Urinary Bladder, Overactive / pathology
  • Urinary Retention / diagnosis
  • Urinary Retention / drug therapy
  • Urinary Retention / pathology
  • Urology*

Substances

  • Adrenergic alpha-Antagonists
  • Cholinergic Antagonists